title: Peritumoral deposits as an adverse prognostic indicator of colorectal cancer.
abstract: BACKGROUND
  The aim of this study was to determine the prognostic value of peritumoral deposits (PTDs) in colorectal cancer (CRC).
  
  
  METHODS
  A total of 695 patients with pT3/T4 CRC (1980 to 1999) were reviewed. Tumor deposits located ≥2 mm from the front of the direct spread in the primary tumor were evaluated as PTDs.
  
  
  RESULTS
  PTDs were observed in 111 patients (16.0%). The incidence of PTDs increased according to increasing N stage: 7% for N0, 22% for N1, and 39% for N2 (P < .0001). Five-year disease-specific survival was 85.0% in patients without PTDs and 59.5% in those with PTDs (P < .0001). Multivariate analysis showed that PTDs affected disease-specific survival independent of T and N stages. A significant prognostic impact of PTDs was similarly observed in another cohort comprising 474 patients with pT3/T4 CRC (2000 to 2005). The κ values among 8 observers were .70 for PTDs and .32 for the conventional growth pattern.
  
  
  CONCLUSIONS
  PTDs have considerable prognostic relevance and offer improved judgment reproducibility in assessing the invasive margin of CRC.
authors.affiliation: Department of Surgery, National Defense Medical College, 3-2, Namiki, Tokorozawa, Saitama 359-8513, Japan. Electronic address: ueno@ndmc.ac.jp.
authors.forename: Hideki
authors.initials: H
authors.lastname: Ueno
authors.affiliation: Department of Surgery, Teikyo University School of Medicine, Tokyo, Japan.
authors.forename: Yojiro
authors.initials: Y
authors.lastname: Hashiguchi
authors.affiliation: Department of Laboratory Medicine, National Defense Medical College, Tokorozawa, Japan.
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Shimazaki
authors.affiliation: Department of Surgery, National Defense Medical College, 3-2, Namiki, Tokorozawa, Saitama 359-8513, Japan.
authors.forename: Eiji
authors.initials: E
authors.lastname: Shinto
authors.affiliation: Department of Surgery, National Defense Medical College, 3-2, Namiki, Tokorozawa, Saitama 359-8513, Japan.
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Kajiwara
authors.affiliation: Department of Laboratory Medicine, National Defense Medical College, Tokorozawa, Japan.
authors.forename: Kuniaki
authors.initials: K
authors.lastname: Nakanishi
authors.affiliation: Department of Laboratory Medicine, National Defense Medical College, Tokorozawa, Japan.
authors.forename: Kei
authors.initials: K
authors.lastname: Kato
authors.affiliation: Department of Laboratory Medicine, National Defense Medical College, Tokorozawa, Japan.
authors.forename: Kazuya
authors.initials: K
authors.lastname: Maekawa
authors.affiliation: Laboratory for Mathematics, National Defense Medical College, Tokorozawa, Japan; Laboratory for Statistical Analysis, Center for Genomic Medicine, RIKEN, Yokohama, Japan.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Nakamura
authors.affiliation: Department of Surgery, National Defense Medical College, 3-2, Namiki, Tokorozawa, Saitama 359-8513, Japan.
authors.forename: Junji
authors.initials: J
authors.lastname: Yamamoto
authors.affiliation: Department of Surgery, National Defense Medical College, 3-2, Namiki, Tokorozawa, Saitama 359-8513, Japan.
authors.forename: Kazuo
authors.initials: K
authors.lastname: Hase
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015179:Colorectal Neoplasms / Q000401:mortality / Q000473:pathology*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D015994:Incidence; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors
keywords: Colorectal cancer; Growth pattern; Invasive margin; Peritumoral deposits; Prognosis